Provider Demographics
NPI:1881309409
Name:CLAH, ERENA TONEE (RBT)
Entity type:Individual
Prefix:
First Name:ERENA
Middle Name:TONEE
Last Name:CLAH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:ERENA
Other - Middle Name:TONEE CLAH
Other - Last Name:KOLB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:1443 W 800 N STE 103
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2878
Mailing Address - Country:US
Mailing Address - Phone:801-655-4950
Mailing Address - Fax:
Practice Address - Street 1:660 N AIRPORT RD
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-8401
Practice Address - Country:US
Practice Address - Phone:435-586-4078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT22-251053106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician